Provider Demographics
NPI:1063956688
Name:BERTORELLI, ASHLEY F (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:F
Last Name:BERTORELLI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:STEPHENTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12169-1809
Mailing Address - Country:US
Mailing Address - Phone:518-477-3516
Mailing Address - Fax:518-776-1070
Practice Address - Street 1:16 N GREENBUSH RD STE 203
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8581
Practice Address - Country:US
Practice Address - Phone:518-326-3771
Practice Address - Fax:518-776-1070
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030379-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist